(Sections 100 (2), 103 (2) and 155 (3))
Issuing officer's initials □
Ballot paper
Electoral District of (here insert name of district)
Write the number 1 in the square next to the candidate of your choice.
*You can show more choices, if you want to, by writing numbers in the other
squares, starting with the number 2.
Fold this ballot paper so your vote cannot be seen and place it in the ballot
box (or in the envelope provided).
Candidates**
□
□
□
□
□
□
*These words may be excluded where there are only 2 candidates.
**Insert after the name of each candidate, if appropriate, the name of a registered party or the word "Independent".
Insert the candidate's logo or the registered party logo of the candidate's registered party adjacent to the name of the candidate, if appropriate.